Pilomatrix-like High-Grade Endometrioid Carcinoma of the Ovary: Case Report, Literature Review, and Differential Diagnosis

Pilomatrix-like high-grade endometrioid carcinoma (PiMHEC) has recently been described as an aggressive variant of endometrial carcinoma. Herein, we described a case of ovarian PiMHEC, comparing it to endometrial PiMHEC and assessing previously published cases of putative ovarian PiMHEC. A 65-year-o...

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Bibliographic Details
Published in:Diagnostics (Basel) 2022-12, Vol.12 (12), p.3146
Main Authors: Santoro, Angela, Travaglino, Antonio, Valente, Michele, Arciuolo, Damiano, Scaglione, Giulia, D'Alessandris, Nicoletta, Sfregola, Stefania, Addante, Francesca, Fulgione, Caterina, Raffone, Antonio, Minucci, Angelo, Inzani, Frediano, Zannoni, Gian Franco
Format: Article
Language:English
Subjects:
Cancer
Carcinoma
Case Report
Case reports
Case studies
Cytokeratin
Diagnosis
Diagnosis, Differential
endometrioid carcinoma
Endometrium
Estrogen
Estrogens
Fallopian tubes
ghost cell
Immunohistochemistry
Literature reviews
Methods
Morphology
Mutation
Ovarian cancer
Ovaries
pilomatrix carcinoma
Progesterone
shadow cell
squamous
Tumors
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Summary:Pilomatrix-like high-grade endometrioid carcinoma (PiMHEC) has recently been described as an aggressive variant of endometrial carcinoma. Herein, we described a case of ovarian PiMHEC, comparing it to endometrial PiMHEC and assessing previously published cases of putative ovarian PiMHEC. A 65-year-old woman underwent hysterectomy for an ovarian tumor characterized by solid nests of basaloid cells with prominent ghost cell keratinization. Immunohistochemistry showed nuclear β-catenin and CDX2 expression and loss of estrogen and progesterone receptors and PAX8. These features were consistently observed in all previously published cases and may represent diagnostic criteria of PiMHEC. Other frequent features were geographic necrosis and a low-grade endometrioid component. CK7, neuroendocrine, and basal/squamous markers were inconsistently expressed. All cases with available follow-up showed poor prognosis. PiMHEC should be distinguished from mimickers, such as high-grade endometrioid carcinoma with geographic necrosis, low-grade endometrioid carcinoma with ghost cell keratinization, and undifferentiated/dedifferentiated carcinoma. In conclusion, PiMHEC can also occur in the ovary and shows several consistent clinical, morphological, and immunophenotypical features. These features support that PiMHEC is a distinct entity requiring an aggressive management.
ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics12123146